Healthcare IT News - November 2007 - (Page 41) www.HealthcareITNews.com CLINICAL TOOLKIT November 2007 ■ Healthcare IT News 41 Healthcare looks to bridge the distance Telemedicine or telehealth? Either way, it’s gaining favor in remote areas. By John Andrews, Contributing Editor R egardless of whether it’s called telemedicine or telehealth, the practice of using telecommunications for patient care appears to be gaining traction among providers – especially those in rural areas. Though in existence (at least conceptually) for more than 20 years, providers have historically perceived telemedicine/telehealth as unrealistic. But with the advance of electronic communications – most notably in the wireless and satellite domains – healthcare organizations are embracing the idea of using information and communications technology for remote patient care. Some, like the University of Texas Medical Branch at Galveston, have been using telemedicine for more than a decade. UTMB serves an average of 60,000 patients a year, including scientists in Antarctica, with its telemedicine system, which began as a service for the Texas state correctional system. UTMB uses the synergy between the electronic medical record and telecommunications for diagnostic services, consultations and health monitoring. Since launching the system in 1993, state officials estimate they have saved more than $1 billion in healthcare costs. “For us this is no longer an experiment,” said Glenn Hammack, MD, assistant vice president and executive director of the UTMB Electronic Health Network. “We had a niche, a unique healthcare program where we provided all healthcare services to prisoners in the state of Texas. It became a recognized cost cutter and grew rapidly from there. By 2000 we had telemedicine stations in 130 prisons.” “Telehealth” is gaining favor as the reference of choice over the long-established “telemedicine,” though there is confusion over whether they refer to the same thing. The general consensus is that they do, though to Hammack there are distinctions. “In Europe they are an equal wash – referring to a gaggle of a zillion possible programs,” he said. “In the states, ‘telemedicine’ usually means information sharing between professionals, such as teleradiology, online clinical information and education programs. ‘Telehealth’ is more a practical application of healthcare services.” In the lower 48, there is probably no more rural landscape than that found in the states of Nebraska and Kansas. It’s not uncommon for people to live 50 miles or more from the nearest town, and round trips to a hospital or clinic can take a whole day. This can pose problems for renal patients who need kidney dialysis treatments three or four times a week, said Larry Emerson, CEO of the Dialysis Center of Lincoln (Nebraska). To close the logistical gap between doctors and patients, DCL recently implemented a telecom system employing three mobile clinical workstations from Norcross, Ga.-based Flo Healthcare. The organization has four outpatient dialysis units in Nebraska, two in Lincoln, one in Columbus and one in Beatrice. “Because of our remote locations in Beatrice and Columbus, we wanted to use real-time video and audio to connect patients more closely with our physicians and nurse Healthcare providers are increasingly turning to telemedicine to keep track of remote patients or to stay in contact with rural clinics. Above, the Dialysis Center of Lincoln (Nebraska) uses mobile clinical workstations from Norcross, Ga.based Flo Healthcare. practitioners, whether it is for telehealth, conferencing, or educational purposes,” Emerson said. POC-EMR KEy Those in the field say the establishment and advancement of point-of-care technology along with the electronic medical record has played a major role in facilitating telemedicine/telehealth adoption. In DCL’s case, they envisioned the system and brought it to Flo for implementation. “They did their homework, asked us if we could do it and we said ‘no problem,’” said Fouad Abu-Akel, director of wireless solutions for Flo. “This is one of the first major implementations we’ve done. It required a lot more customization than a standard point-of-care device, adding in voice conferencing and video conferencing as well as enabling wireless on all their systems.” Because the DCL project is still in an early phase of implementation, Emerson and AbuAkel say it will take some time before historical data can be processed and evaluated. Going forward, Flo expects to be involved in more EMR/telehealth implementations, but Abu-Akel strongly advises providers to determine their own purpose for their system. “Don’t get this technology just because it is believed to be the ‘latest and greatest’ – it is easy to jump the gun that way,” he said. “Hospitals need to look at what their needs are and know the task at hand. Go beyond the buzz words and find a system that works.” PATIENT suRvEILLANCE As if the telehealth-telemedicine terminology tandem weren’t enough to keep track of, another component – called telemonitoring – is also part of the category. But Jeneane Brian, clinical executive with Raleigh, N.C.-based Misys Healthcare Systems, Jeneane Brian says unlike the other two, the definition of telemonitoring is clear. “Telehealth is a subset of assistive technology and telemonitoring is a narrower view of telehealth,” she said. “Telemonitoring is a consistent or intermittent look at patients’ vital signs and other lab readings by way of a wearable hardware device in the home.” Becoming more common as a home health surveillance tool, electronic monitoring devices can have various forms, including wrist and ankle bracelets, vests and wristwatches. Some monitors can be installed on equipment, such as a bed or wheelchair, which signals when a patient gets up. Telemonitoring is also turning out to be an effective disease management tool, enabling medical professionals to “drop in” on diabetic, pulmonary and heart patients between office visits and check key vital signs, such as blood pressure. That way, physicians and nurses can detect whether a patient is staying within behavioral parameters. “If a patient is on a salt-restricted diet and had ham and margaritas the night before, the system will alert the nurse,” Brian said. “It is an effective way for healthcare providers to be there for their patients.” ■ More At healthcareITnews.com e Connect: teLeMediciNe 1107 ● Leading Health Information Technology experts agree that Electronic Document Management (EDM) is a key foundation for the EHR. Combining electronically generated data with scanned records provides an organized, centrally located, legally compliant medical record which is critical to improve efficiencies, patient care and cash flow. Let Alpha Systems help guide you with our safe and trustworthy EDM solutions. e ● Connect: ALPHA 1107 The nation's leading healthcare providers trust Alpha Systems for rock solid EDM software and award winning scanning services. 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